Purpose: The purpose of our study is to examine early radiographic findings and clinical signs of failure of the microstructure surface HA-coated acetabular cup. Material and methods: This study included 41 revisions of 204 THA with hydroxyapatite-coated acetabular cup from April 1992 to November 1996. Radiolucent line around cups, change in the cup angle and osteolysis were evaluated in serial radiographs. Acetabular cup was defined as loosening if any movement occurred at the bone and socket interface by manual rotation and extension force intraoperatively or migration of more than 2 mm and change of the cup angle by more than 5 degrees in radiographs. Results: The radiolucent line was observed in 12 of the 41 hips at an average of 55.4 months postoperatively and was most commonly located in zone III. All of the 12 hips showing radiolucent lines were classified as loosening by radiographically in 8 cases and intraoperatively in 4 cases. Radiographic loosening occurred at an average of 28.8 months after the appearance of a radiolucent line. Inguinal pain was noted in 18 of the 19 cases revised for acetabular cup loosening. Conclusion: The most important radiographic finding for the early diagnosis of loosening was progressive radiolucent lines, which occurred most frequently in zone 3.
Acetabulum* ; Arthroplasty, Replacement, Hip ; Early Diagnosis ; Hip ; Osteolysis

Acardiac twinning affects 1 in 100 monozygotic twin pregnancies and 1 in 35,000 pregnancies overall. This condition is characterized by the absence or rudimentary development of fetal heart, and associated with various anomaly. The presence of an acardiac twin requires the normal (or "pump") twin to provide circulation for itself, as well as the acardiac sibling. The acardiac malformations are uniformly fatal in the affected twin, and mortality in the co-twin is as high as 55%. The principal perinatal problems associated with acardiac twinning are pump-twin congestive heart failure, maternal hydramnios, and preterm delivery. We recently experienced a case of acardius anceps associated with a normal male infant, so present with a brief review of the literature.
Fetal Heart ; Heart Failure ; Humans ; Infant ; Male ; Mortality ; Polyhydramnios ; Pregnancy ; Siblings ; Twins, Monozygotic

No abstract available.
Forehead* ; Methylmethacrylate*

Statement of problem: A conventional 3-unit fixed partial denture design with a pontic between two retainers is the most commonly used. However, in cases where the mental nerve is in close proximity to the second premolar, a cantilever design can be considered. As such, logical and scientific evidence is lacking for the number and position of implants to be placed for partially edentulous patients, and no clear-cut set of treatment principles currently exist. Purpose: The purpose of this study was to evaluate prognosis of implant-supported fixed partial dentures, and to compare changes in bone level which may rise due to the different factors. Material and method: The present study examined radiographical marginal bone loss in patients treated with implant-supported fixed partial dentures(87 prostheses supported by 227 implants) and evaluated the influence of the span of the pontic, type of the opposing dentition. Clinical complications were studied using a retrospective method. Within the limitation of this study, the following result were drawn. Result: 1. Seven of a total of 227 implants restored with fixed prostheses failed, resulting in a 96.9% success rate. 2. Complications encountered during recall appointments included dissolution of temporary luting agent (17 cases), porcelain fracture (8 cases), loosened screws (5 cases), gingival recession (4 cases), and gingival enlargement (1 case). 3. Marginal bone loss, 1 year after prosthesis placement, was significant(P<0.05) in the group that underwent bone grafting, however no difference in annual resorption rate was observed afterwards. 4. Marginal bone loss, 1 year post-placement, was greater in cantilever-type prostheses than in centric pontic protheses(P<0.05). 5. Marginal bone loss was more pronounced in posterior regions compared to anterior regions(P<0.05). 6. The degree of marginal bone loss was proportional to the length of the pontic(P<0.05). Conclusion: The success rate of implant-supported fixed partial dentures, including marginal bone loss, was satisfactory in the present study. Factors influencing marginal bone loss included whether bone graft was performed, location of the pontic(s), location of the surgical area in the arch, pontic span. Long-term evaluation is necessary for implant-supported fixed partial dentures, as are further studies on the relationship between functional load and the number of implants to be placed.
Appointments and Schedules ; Bicuspid ; Bone Transplantation ; Dental Cements ; Dental Porcelain ; Dentition ; Denture, Partial, Fixed ; Gingival Recession ; Humans ; Logic ; Prognosis ; Prostheses and Implants* ; Retrospective Studies ; Transplants

The thirteen DRB1, 6 DQA1, and 5 DQB1 alleles were defined in 362 healthy Korean controls using reverse dot blot hybridization method. The twenty-four immobilized SSOs for DRB1, 8 for DQA1, and 6 for DQB1 were used for this study. The frequencies of genotypes were DRB104 (17.1'Yo), '09 (13.1%), and '13 (11.6%); DQA1'01 (46.7%), 03 (30.8%), and '05 (11.7%); DQB1*03 (39.5%), '06 '(29.8%), and 05 (16.0%). ...continue...
Alleles* ; Genotype ; Haplotypes* ; HLA-DRB1 Chains

BACKGROUND: The concept of myocardial injury after coronary occlusion is changing in recent years. Brief episode of ischemial induces reversible myocardial injury and repeated brief ischemic insults might cause myocardial necrosis due to cummulative damages. Recent observations showed that brief episodes of ischemia have protective effects on the myocardium increasing the myocardial tolerance to a subsequent sustained ischemic insult. This phenomenon is termed ischemic preconditioning and can be noticed after a variety of protocols in multiple species of experimental animals. This study was planned to 1) measure the changes of hemodynamic parameters and the ischemic damage of insulted myocardium during ischemic preconditioning, and 2) compare the infarct sizes with or without preconditioning. METHODS: Using canine model of a single 90 minutes' occlusion of left anterior descending coronary artery and 240 minutes' reperfusion, 14 mongrel dogs were randomized to with(n=7) or without(n=7) ischemic preconditioning such as four 5 minutes' occlusion and 5 minutes' reperfusion, Changes of hemodynamic parameters and extents of the ischemic myocardial damages during preconditioning were observed. And using in vitro myocardial staining with monastral blue and triphenyl tetrazolium chloride, we compared the infarct sizes and risk areas in two groups of occlusion and reperfusion canine model with and without preconditioning. RESULTS: 1) Heart rate was significantly decreased after first 5 minutes' occlusion compared with those of basal control(151+/-27 VS 163+/-25 BPM, p<0.05) without further changes in subsequent ischemic insults. Left ventricular systolic pressure was significantly decreased after first 5 minutes' occlusion(109.0+/-19.9 VS 130.6+/-23.3mmHg, p<0.005), and after first 5 minutes' reperfusion and second 5 minutes' occlusion compared with those of basal control(111.3+/-29.8, 109.9+/-17.2 VS 130.6+/-23.3mmHg respectively, p<0.05), without further changes during remaining ischemia. Left ventricular end diastolic pressure and maximum +dp/dt were not changed. Peak -dp/dt was decreased significantly after first and second 5 min occlusion(943.7+/-294.4, and 962.1+/-281.5) from basal control level(1168.2+/-358.8mmHg, p<0.05). Thereafter no change was noted during remaining preconditioning. The changes in rate-pressure product were same as those of left ventricular systolic pressure(first 5 minutes occlusion ; 17.3+/-3.7 VS 21.2+/-3.5, p<0.005, second 5 minutes' occlusion ; 17.9+/-5.3, 18.1+/-3.4 VS 21.2+/-3.5, p<0.05). 2)Transmyocardial lactate extraction ratio was significantly decreased in early phase of ischemic preconditioning(17.5+/-11.3 VS 25.2+/-9.9%, p<0.05). 3) Hemodynamic parameters such as heart rate, left ventricular systolic pressure, left ventricular end-diastolic pressure, maximum +dp/dt, peak -dp/dt and rate-pressure product were changed similarly in both control and precontioned groups. 4) There was no significant difference of mean myocardial blood flows in infarct zones, which represent collateral blood flow, after 5 minutes' brief occlusion and 60 minutes of sustained occlusion in preconditioned group. 5) The infarct area/risk area ratio was significantly reduced in preconditioned group(27.0+/-9.6 VS 5.6+/-3.1%, p<0.005), but the risk area/left ventricular area ratio showed no difference in the two groups. CONCLUSIONS: These findings suggest that, in the early phase of brief repeated occlusion and reperfusion, myocardial ischemic damage accompaning systolic and diastolic myocardial dysfuctions develops and myocardial protective effect of ischemic preconditioning was obtained at the same time. Ischemic preconditioning group demonstrated reduced infarct sizes compared to those of control group after 90 minutes' sustained ischemia and reperfusion in canine acute myocardial infarction model.
Animals ; Blood Pressure ; Coronary Occlusion ; Coronary Vessels* ; Dogs ; Heart Rate ; Hemodynamics ; Ischemia ; Ischemic Preconditioning* ; Lactic Acid ; Myocardial Infarction ; Myocardial Reperfusion ; Myocardium ; Necrosis ; Reperfusion

BACKGROUND: Early death is an important problem associated with the management of community-acquired pneumonia. However, there is little information on the risk factors associated with it. The aim of this study was to identify the factors associated with early death in community-acquired pneumonia patients. METHODS: From January 1999 to July 2004, 1,487 adult patients with community-acquired pneumonia who were admitted to the pulmonary department via emergency center were examined. Early death was defined as those who died within 2 days of hospitalization. The clinical and laboratory aspects of the patients who died early (n=30) were compared with those of an age and gender matched control population (n=60) . RESULTS: In the early death group, respiratory rate, heart rate, and blood urea nitrogen (BUN) were significant higher (p<0.05 for all), while the arterial pH, systolic pressure, and PaO2 were significant lower (p<0.05 for all) than the control. The independent factor significantly associated with early death was tachypnea (OR, 7.049). CONCLUSION: The importance of an early clinical assessment in emergency center with community-acquired pneumonia needs to be emphasized in order to recognize patients at risk of early death.
Adult ; Blood Pressure ; Blood Urea Nitrogen ; Emergencies ; Heart Rate ; Hospitalization ; Humans ; Hydrogen-Ion Concentration ; Pneumonia* ; Respiratory Rate ; Risk Factors ; Tachypnea

PURPOSE: To detect differentially expressed genes in the patients with uterine cervical cancer during the radiation therapy. MATERIALS AND METHODS: In patients with biopsy proven uterine cervical cancer, we took a tumor tissue just before radiation therapy and at 40 minutes after external irradiation of 1.8 Gy. Total RNAs isolated from non-irradiated and irradiated tumor tissue samples were analyzed using the differential-display reverse transcription-polymerase chain reaction (DDRT-PCR). Complementary DNA (cDNA) fragments corresponding to differentially expressed messenger RNAs(mRNAs) were eluted, and cloned. The differential expression of the corresponding mRNAs was confirmed by reverse northern blot. Differentially expressed cDNA bands were sequenced. Nucleotide sequence data were analyzed in the Gene Bank and EMBL databases via the BLAST network server to identify homologies to known genes or cDNA fragments. Expression pattern of down-regulated clone was examined using RT-PCR in 5 patients undergoing radiotherapy. RESULTS: We identified 18 differentially expressed bands by DDRT-PCR, which were eluted and cloned. There were 10 up-regulated clones and 1 down-regulated clone in reverse northern blot. One cDNA fragment had homology to chemokine receptor CXCR4, four were identified as Human ESTs in the EMBL database in EST clones. Down-regulated CxCa-11 was also down regulated in all patients. CONCLUSION: Using the DDRT-PCR, we have identified 10 up-regulated and 1 down-regulated clone(s) in the patients with uterine cervix cancer during the radiation therapy. The clinical relevance and the functions of these genes will be further investigated.
Base Sequence ; Biopsy ; Blotting, Northern ; Cervix Uteri* ; Clone Cells ; DNA, Complementary ; Expressed Sequence Tags ; Female ; Humans ; Radiotherapy* ; RNA ; RNA, Messenger ; Uterine Cervical Neoplasms

PURPOSE: Acute appendicitis is one of the most common diseases requiring surgical treatment. Delayed diagnosis, which causes complications like perforation of the appendix, abscess formation, or misdiagnosis, leads to unnecessary surgery. Many scoring systems have been suggested for the diagnosis of acute appendicitis. This study aims to evaluate the clinical value of previous scoring systems. METHODS: This study was conducted with a total of 270 patients who had visited the National Police Hospital (NPH) Emergency Room for acute abdominal symptoms from January to June 2008. The Alvarado and the Ohmann scores were applied retrospectively based on the patients' records. We found 3 criteria which were relatively objective and clinically meaningful; then, we designed a new 10 points scoring system. RESULTS: The sensitivity and the specificity of the Alvarado scoring system were 83.23% and 64.42%, respectively, whereas those of the Ohmann scoring system were 74.85% and 66.35%, respectively. The sensitivity and the specificity of the NPH scoring system were found to be 78.4% and 68.9%, respectively. The Ohmann scoring system showed a little lower sensitivity, and the NPH scoring system showed a little higher specificity, but the differences were not statistically significant. CONCLUSION: Our study indicates that the scoring systems considered are not useful diagnostic methods for primary screening and diagnosis of acute appendicitis.
Abscess ; Appendicitis ; Appendix ; Delayed Diagnosis ; Diagnostic Errors ; Emergencies ; Humans ; Mass Screening ; Police ; Retrospective Studies ; Sensitivity and Specificity ; Unnecessary Procedures

To evaluate left ventricular diastolic function in patients with coronary artery disease, gate radionuclide ventriculography was performed prospectively in 42 patients who were admitted to Seoul National University Hospital from November 1985 to August 1986 because of anterior chest pain. All patients had no valvular heart disease, congenital heart disease, cardiomyopathy and arrhythmia, and no abnormal vall motion in gated nuclide ventriculography and contrast left ventriculography. 25 patients with more than 50% of stenosis in coronary arteriography were compared with 17 control subjects without stenosis. The following results were obtained; 1) There were no significant differences between normal controls and patients with coronary artery disease in the analysis of the parameters of the left ventricular systolic function, such as ejection fraction (EF), peak ejection rate (PER), time to peak ejection rate (TPER) and ejection time (TES, TES/BCL). 2) Same results were found with those of the left vnetricular diastolic function, such as peak filling rate (PFR), diastolic time interval (DTI, DTI/BCL), rapid diastolic filling interval and time to late diastolic filling (TLDF). 3) The percent contribution of late diastolic filling to stroke volume (%LDF/SV) was more increased in patients with coronary artery disease than the normal control subjects (38.2+/-12.4% vs 28.3+/-7.8%, P<0.01). 4) As the results of above, it can be concluded that the percent contribution of late diastolic filling to stroke volume (%LDF/SV) obtained by using the non-invasive method of gated radionuclide ventriculography can be a sensitive parameter for early evaluation of the left ventricular diastolic dysfunction in coronary artery disease.
Angiography ; Arrhythmias, Cardiac ; Cardiomyopathies ; Chest Pain ; Constriction, Pathologic ; Coronary Artery Disease* ; Coronary Vessels* ; Gated Blood-Pool Imaging ; Heart Defects, Congenital ; Heart Valve Diseases ; Humans ; Prospective Studies ; Radionuclide Ventriculography ; Seoul ; Stroke Volume